Opening a medical spa, or med spa, is an exciting and rewarding business venture, but it comes with its own set of challenges, particularly around legal requirements. Med spas operate at the intersection of medical care and beauty, meaning medical and business regulations apply. Ensuring compliance with these rules is essential to avoid costly legal issues. This guide will walk you through the fundamental licensing and ownership requirements to open a compliant and successful medical spa.
What is a Medical Spa?
A medical spa, commonly known as a “med spa,” is a hybrid between a medical clinic and a day spa. Med spas provide non-invasive, non-surgical medical aesthetic treatments under the supervision of a licensed physician. The services typically focus on enhancing clients’ appearance through various medical and cosmetic treatments, such as Botox, dermal fillers, laser hair removal, chemical peels, and skin rejuvenation therapies.
Unlike day spas, med spas must meet stricter regulatory standards because they provide medical treatments. The four core elements of a medical spa are:
- Non-invasive aesthetic medical services: Treatments that do not require surgery, such as injectables, chemical peels, laser treatments, IV treatments, and weight loss treatments.
- Supervision by a licensed physician: All medical procedures must be supervised by a licensed physician, even if the physician does not perform them.
- Qualified practitioners: The treatments are administered by trained and experienced professionals, such as registered nurses (RNs), nurse practitioners (NPs), or physician assistants (PAs).
- Onsite supervision: A licensed healthcare professional must be on site during treatments to ensure proper oversight and patient safety.
Who Can Own a Medical Spa?
Ownership of a medical spa varies significantly by state. In many states, only licensed physicians can own and operate a medical spa, as the treatments offered fall under the medical services. The reasoning behind this is that med spa treatments, though non-invasive, are still considered medical procedures and, therefore, require stringent regulatory oversight.
However, in many states, non-physicians can own a medical spa using a Management Services Organization (MSO) model. In this structure, the non-physician owner creates an MSO, which manages the business aspects of the med spa, such as hiring staff, managing payroll, marketing, and overseeing operations. The medical services are provided by a physician who has entered into a Management Services Agreement (MSA) with the MSO. This approach allows non-physicians to be involved in the business without violating state laws regarding the corporate practice of medicine.
State-by-State Ownership Examples
Let’s take a look at the ownership requirements for medical spas in some key states:
California:
California has strict regulations on who can own a medical spa. Only physicians can own a medical practice or a medical spa. However, licensed non-physicians such as nurse practitioners (NPs) and registered nurses (RNs) may own up to 49% of the business. This means that medical spas in California must be owned by a licensed physician or a professional medical corporation where physicians own the majority stake (at least 51%). The corporate practice of medicine prohibits lay people from owning medical practices in California, but through the MSO model, non-physicians can manage the business aspects. For example, a physician can own 100% of the medical entity, and a non-physician can own 100% of the MSO.
Connecticut:
In Connecticut, the regulations are more lenient. Non-physicians can directly own a medical spa, and the state does not require the use of an MSO for ownership. However, licensed professionals, such as physicians, nurse practitioners, or physician assistants, must perform all medical procedures in the spa. Public Act No. 14-119 requires professionals within a professional corporation to be licensed or certified to render the services for which the corporation was established.
Florida:
In Florida, either a licensed physician or a physician group practice can own a med spa. A non-physician may also own the business but cannot direct or control the medical services provided. All medical treatments must be administered under the supervision of a licensed physician, ensuring that non-physicians do not have authority over the clinical aspects of the spa.
Georgia:
Georgia allows physicians and registered nurses to co-own a medical spa with equal ownership. The physician will act as the medical director, overseeing the spa’s medical services, while the nurse co-owner manages the clinical practice. Both owners must have the necessary qualifications and training to provide medical spa services.
Ohio:
Ohio allows RNs, PAs, NPs, and even business people to own medical practices through an LLC. Non-physicians can own a med spa directly, but licensed healthcare professionals, such as physicians, RNs, NPs, or PAs, must provide medical treatments. Ohio does not restrict non-physician ownership as long as the spa complies with medical oversight regulations.
Texas:
In Texas, the law allows for a co-ownership model where a physician and a physician assistant (PA) can co-own a medical spa. However, the PA must hold a minority stake, and the physician must retain control over the medical services offered. The PA cannot have an officer or managing member position within the business to ensure that the physician supervises medical services.
The Importance of Licensing for Medical Spas
The proper licenses are critical to opening and operating a medical spa. A medical spa is considered a medical practice, meaning it falls under the regulation of both medical boards and other state agencies. You could face legal penalties without the correct licenses and permits, including fines, business closure, or loss of professional licenses.
Proper licensing ensures that the medical professionals providing treatments are qualified, the facility operates safely and meets state and local regulatory standards. Additionally, medical spas are often subject to inspections by health and safety boards, so compliance with regulations is essential to avoid disruptions to your business.
Essential Licenses and Permits for a Medical Spa
Here are some standard licenses and permits that you will need to obtain when opening a medical spa:
- Business License: Every medical spa needs a general business license to operate. You can typically apply for this through your state’s Department of Business Regulation or the U.S. Small Business Administration (SBA).
- Medical Licenses: A medical spa must have a licensed physician or healthcare professional supervising or providing medical treatments, such as a nurse practitioner or physician assistant. These professionals must hold valid state medical licenses.
- Certificate of Occupancy: This license verifies that your spa location meets local zoning and safety regulations. Before you can open your spa, you’ll need to undergo an inspection by local government agencies to ensure that the building complies with zoning laws, fire safety codes, and other regulations.
- Health Department Permits: Depending on your state, you may need to obtain a health department permit to ensure that your spa complies with hygiene, sanitation, and safety regulations.
- Retail Seller Permit: If your medical spa sells products such as skincare items or cosmetics, you may be required to obtain a retail seller permit from your state’s revenue department.
- Building Permits: If you are making any renovations or structural changes to your spa location, you must obtain building permits and pass inspections from local authorities to ensure compliance with safety regulations.
State-Specific Licensing Examples
Florida:
The Florida Department of Health requires a license for cosmetology salons and medical spas. This license ensures that the facility meets state safety and sanitary standards. The application process involves submitting forms to the department, including details about the spa’s ownership and medical professionals.
Georgia:
In Georgia, med spas must apply for a salon license through the Georgia State Board of Cosmetology. The state requires that the spa comply with all regulations governing salons and meet safety and health standards.
Virginia:
In Virginia, medical spas offering esthetic services must obtain an esthetics spa license, particularly if they provide master esthetics services, such as chemical peels or lymphatic drainage. All practitioners must be licensed, and the spa must comply with the Board of Cosmetology’s regulations.
New Jersey:
Certain medical spas in New Jersey must obtain a facility license from the New Jersey Department of Health. The facility license ensures that the spa meets state health, safety, and professional standards. The application process involves submitting paperwork detailing the medical professionals involved and ensuring the facility complies with health department regulations.
California:
Certain medical spas must apply for a medical establishment license to operate in California. The application process involves meeting labor and safety standards and submitting detailed information about the spa’s ownership and medical staff.
Conclusion
Opening a medical spa requires a thorough understanding of both business and medical regulations. Each state has requirements for ownership, licensing, and permits; it is crucial to comply with them to avoid legal complications. Whether you are a physician or a non-physician seeking to own a medical spa, working with a legal expert to navigate these regulations will ensure your business operates smoothly and does not subject you to a high level of liability. Proper licensing protects your business from legal issues and helps ensure that you provide safe, high-quality care to your clients.